Ob-Gyn Coding Alert

Question: My ob-gyn performed a myomectomy at the same time as a c-section. Should I report 59510 with modifier 22? Or is there another code that should be used?

New York Subscriber

Answer: The c-section and the myomectomy are not bundled, so you should not use modifier 22 (Increased procedural service) on code 59510 (Routine obstetric care including antepartum care, cesarean delivery, and postpartum care).

You should bill either 58140 (Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250g or less and/or removal of surface myomas; abdominal approach) or 58146 (Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250g, abdominal approach) as a secondary code with modifier 51 (Multiple procedures).